Bursary Application: CTRLshift Summit 2019
This is a simple application form for our bursary fund for CTRLshift Summit 2019.
We aim to have available (subject to funding) the following bursaries:
Full Bursary: * 5 Paid-for Places + up to £100 Expenses towards travel & accommodation
Attendance Bursary * 20 Paid-for Places at the Summit
Partial Bursary * 10 Subsidised Places at £50 each
All bursaries are for the full period of the event.
The level of demand for these bursaries is not known at this stage. If the demand is higher than availability we will give priority to ensuring diversity in the room at the event. This applies to gender; ethnicity; sectors that you work in and the turnover and size of your organisation. We also wish to encourage working class attendees and there is a question to that effect.
Priority will also be given to local organisations from the Stoke-On-Trent Area.
To ensure inclusive and diverse participation we encourage people who identify as BAME , LGBTQ+, disabled, women, working class and young people to apply.
If there are more applications than available for the Full Bursary package, we may decide to allocate additional places from the Attendance and Partial Bursary Funds at our discretion. If you apply for a Bursary but do not qualify, we will aim to at first offer you the next best option.
The first round of decisions will be made over the period of 1st-5th April 2019. Any remaining bursaries after that point will be allocated on a first-come, first-served basis.
* Required
Email address
*
Your email
Your Name
*
Your answer
Your Organisation
Your answer
Location of your organisation/network/project (if appropriate)
Your answer
Website Address / Links
Your answer
Phone Number
*
Your answer
Sectors you work in
*
Housing, Planning, Development
Environment
Land
Health & Well Being
Social Justice
Economics
Change & process
Art & Culture
Cooperative/s
Science & Research
Technology
Politics/Democracy
Localisation/Resilience
Poverty / Inequality/ Diversity /Minorities
Ethics/Faith/Religion
Think Tank
Law
Media
Energy & Renewables
Food & Farming
Direct Action / Activism
Education
Funding
Finance/Banking/Money
Rural / Coastal
Gender/Ethnicity/ Marginalised Groups
Other:
Required
Size of your Organisation/Network/Project
*
0-10 Employees/Volunteers
10-25 Employees/Volunteers
25-100 Employees/Volunteers
100+ Employees/Volunteers
N/A
Turnover of your Organisation/Project
*
£0 - £10,000
£10,000 - £100,000
£100,000 - £1million
£1million +
N/A
Bursary Being Applied For
*
Choose
FULL BURSARY - £0 Ticket + Up to £100 Expenses
ATTENDANCE BURSARY - £0 Ticket
PARTIAL BURSARY - £50 Ticket
Please detail the reason you wish to attend CTRLshift and what you would get from this
*
Your answer
Gender
*
Which of these genders, if any, do you identify with
Female
Male
Prefer not to say
Other:
Ethnicity
*
Which ethnicity do you identify with? Please include in 'Other' if the option does not exist below
White British
White European
White (Other)
Mixed/Multiple Ethnic Groups
Asian / British Asian
Black / African / Caribbean / Black British
Prefer not to say
Other:
Do you or have you identified as working class?
*
Yes
No
Prefer not to say
Are you younger than 30 years of age?
*
Yes
No
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Permaculture Association (Britain).
Report Abuse
Forms
